Myocardial dysfunction in human immunodeficiency virus infection: an echocardiographic study.

Abstract

OBJECTIVES: To determine the prevalence and characteristics of myocardial dysfunction and other cardiac manifestations in patients with human immunodeficiency virus (HIV) infection. METHODS: Fifty-two patients with HIV infection were examined and screened for various opportunistic infections. CD4 cell count was done and two dimensional echocardiography was performed. RESULTS: Echocardiographic findings were identified in 22 of 52 patients (42.3%). Eighteen patients (34.6%) were having reduction in fractional shortening, 10 patients (19.2%) left ventricular diastolic dysfunction, 8 patients (15.4%) global hypokinesia and 6 patients (11.5%) pericardial effusion. Nineteen out of 22 patients having CD4 cell count <100 cells/mm3 had high prevalence of echocardiographic abnormalities. Patients with opportunistic infections had more frequent echocardiographic abnormalities than those without opportunistic infections (P < .001 for TB, candidiasis and various pneumonias). CONCLUSION: Although often not diagnosed clinically, cardiac involvement in patients with HIV infection is a clinical reality with pericardial effusion, left ventricular diastolic dysfunction, reduction in fractional shortening and global hypokinesia appearing to have a high prevalence. These echocardiographic findings are associated with clinically apparent opportunistic infections and low CD4 cell count.